Kevin J. Blinder, MD: Feasibility of Home Optical Coherence Tomography for nAMD

Kevin J. Blinder, MD

Credit: The Retina Institute

New research suggested the feasibility of daily home optical coherence tomography (OCT) imaging among patients with treatment-naive neovascular age-related macular degeneration (nAMD).

The results, presented as a late-breaker at the American Society of Retina Specialists (ASRS) 41st Annual Meeting, showed the frequency of scanning and accuracy of fluid detection were sufficient for monitoring fluid remotely, with an overall positive patient experience.

“I think one of the most valuable advantages using this is we can really monitor the fellow eye,” presenting investigator Kevin J. Blinder, MD, The Retina Institute, told HCPLive at ASRS 2023. “The fellow eye with macular degeneration at high risk for developing nAMD. If we can detect the transition early in these patients, we can potentially save them vision.”

Blinder and colleagues indicated the importance of understanding the feasibility and usefulness of Notal Vision Home OCT (NHVO) in clinical practice. However, it is unknown whether NHVO-guided monitoring could improve visual acuity outcomes, reduce treatment burden, and improve early detection of disease progression in the fellow eye in patients with nAMD. As a result, the investigative team conducted a feasibility study to gain a better understanding of these factors.

Study participants were recruited from 3 study centers and were considered eligible if they had active, untreated nAMD and visual acuity of 20/20 to 20/320. Individuals were instructed to scan both eyes on a daily basis using NVHO for a 6-month period. Retina specialists managed treatment according to standard practice and did not have access to the home OCT data.

Fluid presence was detected by a reading center using in-office spectral-domain OCT scans and was compared to fluid volumes measured by the Notal OCT Analyzer. Participants completed a survey on their experiences with the NVHO at the conclusion of the study. The investigative team used descriptive statistics to summarize the results.

Overall, a total of 40 participants met ocular eligibility criteria, with 14 (35%) completing the study. The analysis revealed the most frequent reasons for not participating in the study were planned travel (n = 7; 17.5%) and inadequate cell reception for the upload of images (n = 5; 12.5%).

When considering the scans of only the study eye, the mean number of scans obtained per participant per week was 6.3, taking an average of 47 seconds per scan. Of 2,304 scans, the data showed 86.5% were eligible for fluid quantification. All participants agreed that scanning was easier over time and only a single patient would not want to continue daily scanning.

From the study data, 35 scan pairs were judged as having fluid by in-office OCT. Of these scans, 15 (43%) had >0 to <10 nL and 4 (11%) had 0 nL as measured by NOA. There was no instance of an NOA fluid level ≥10 nL when the in-office OCT showed no fluid.

Blinder and colleagues noted the importance of patient selection for home monitoring, suggesting travel accommodation and Wi-Fi connectivity could improve the uptake of the Home OCT device. Further randomized trials could help fully assess the utility of home OCT in clinical practice.

For more insight into the analysis, watch the full interview with Dr. Blinder below:

Disclosures: Dr. Blinder reports no relevant financial relationships.